Pro-adrenomedullin level in chronic forms of coronary heart disease: relationship with systolic function of the left ventricle

Aim. To assess the level of pro-adrenomedullin in patients with chronic forms of coronary heart disease and to identify possible relationship with the indicators of left ventricular systolic function.

Methods. 110 patients with ischemic heart disease and myocardial infarction with preserved left ventricular ejection fraction [average age 54.9 (42; 64) years] and 130 patients with ischemic cardiomyopathy [average age 55.2 (42; 64) years] were observed. All patients underwent transthoracic echocardiography by a standard technique and pulsed-wave tissue Doppler, left ventricular ejection fraction and myocardial performance index (Tei index) were calculated, maximum systolic velocity of the lateral part of the fibrous ring of the mitral valve was estimated. Pro-adrenomedullin level was measured in serum.

Results. In both groups the level of pro-adrenomedullin was statistically significantly higher than the control va­lues — 0.49 (0.18; 0.58] nmol/L (p <0.017 and p <0.001, respectively). At the same time, in the group of patients with ischemic cardiomyopathy, the level of pro-adrenomedullin was statistically significantly higher than in the group of patients with ischemic heart disease and myocardial infarction with preserved left ventricular ejection fraction [1.72 (1.56; 1.98) nmol/l and 0.89 (0.51; 1.35) nmol/l, p <0.001]. Correlation analysis in both groups revealed statistically significant associations of the pro-adrenomedullin level with the left ventricular ejection fraction (r=–0.45, p=0.039, r=–0.51, p=0.034), maximum longitudinal velocity of the left ventricle (r=0.50, p=0.027, r=0.59, p=0.019), Tei-index (r=0.50, p=0.027, r=0.59, p=0.019).

Conclusion. The data obtained demonstrate the potential of determining the level of pro-adrenomedullin as a biochemical marker of left ventricular dysfunction.